Why it's now time to say `yes' to organ donations

Rory O'Connor was a 31-year-old, originally from Co Dublin, who went to college at the University of Ulster and set up in the…

Rory O'Connor was a 31-year-old, originally from Co Dublin, who went to college at the University of Ulster and set up in the postcard advertising business in Belfast. Rory achieved all this despite having cystic fibrosis, a potentially fatal lung condition. He died in his adopted city last month while awaiting a lung transplant at the Freeman Hospital in Newcastle, as reported in The Irish Times recently.

According to his father, Tom, Rory got the most out of life. However, in May of last year, his lung function deteriorated to the point where transplantation offered his only hope of long term survival. He was assessed in Newcastle and placed on the waiting list for transplantation. "We were given to believe that there was a very good chance that he would be operated on by Christmas," Tom O'Connor said.

Unfortunately, Rory died in February. His father is concerned that one of the reasons his son did not receive a transplant is a downturn in lung and heart donation following the retention of children's organs by hospitals without parental permission and the Alder Hey "scandal" in the UK.

So, has there been a recent reduction in organ donations? According to the Transplant Coordinator's Office at the Freeman Hospital, the organ donation pattern tends to fluctuate. But they have noticed "more troughs than peaks" in the last number of months. Whereas their preferred level of transplant activity would be eight to 10 operations per month, in three of the last four months the number of heart and lung procedures has dropped to two.

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Dr Jim Egan of Dublin's Mater Hospital, the Republic's first transplant physician, says that while there is no hard data yet to confirm a downturn in organ transplantation, individual programmes have reported a fallow period recently. "Many lives depend on the fragile process of organ donation. It is a real life-saving medical intervention and real people see a significant benefit from organ transplantation. Enormous numbers of people have benefited in the past, yet frustratingly, people still die waiting for what is now a standard form of treatment", Dr Egan adds.

While the Irish Kidney Association reports no reduction in requests for organ donor cards, it did notice an increase in the number of refusals to donate by relatives last year. There were 71 donors in the Republic, but an additional 25 cases of "no-to-consent" were recorded. This compares to 1999 figures of 72 donors and only 10 refusals.

But most worryingly of all, in the first 12 weeks of this year, there have only been 10 donors. If this trend continues, it represents a potential 40 per cent reduction in organ donation for this year.

There are currently 5,686 people awaiting organ transplantation in Ireland and the UK. A sustained 40 per cent reduction in donors here will literally spell a death sentence for many of these patients.

The biggest source of donor organs are road accident victims and brain haemorrhage patients. These people are likely to be placed on a ventilator following hospital admission, which is a pre-requisite for using their organs once they have been declared brain dead. This is a rigorous process, in which two different doctors have to carry out a series of independent tests.

Each person can donate a heart, two lungs, two kidneys and a liver as well as the pancreas, two corneas, heart valves and skin grafts. Last year, for example, the 71 donors in the Republic made it possible to carry out 126 kidney transplants, 14 heart and 40 liver transplants.

You are never too old to donate your organs; what matters is your physical condition and not your age. Having an existing medical condition does not prevent you becoming a donor either. While it may rule out a particular organ, ultimately it is the transplant surgeon who decides. He will take into account your past medical history as well as the circumstances of your death.

Some people might worry that they could inadvertently pass on transmissible diseases or viral infections. In fact, blood is taken from all potential donors and tested to make sure this does not happen.

Under existing legislation, organs can be removed only with the prior consent of the patient or with the approval of the family after death. The British Medical Association has suggested the introduction of a system of presumed consent in the UK, which would mean that organs could be taken unless the person had registered an objection during their lifetime. However, there are no such proposals in this country.

It is not too late to reverse the trend in organ donation which is emerging in this country. If you have been affected by negative publicity concerning organ retention, please rethink your attitude to organ donation. You are three times more likely to need organ transplantation than ever to be in the unfortunate circumstances of being a donor. Contact the Irish Kidney Association today at 016689788 for a donor card, sign it and tell your family of your wishes. Each and everyone of us is dependent upon another person making the selfless decision to become an organ donor. Do it today!

Organ Donor Awareness Week runs from March 31st to April 7th.

Dr Muiris Houston, Medical Correspondent, can be contacted at mhouston@irish-times.ie or leave messages on tel 01-6707711, ext 8511, but he regrets he cannot reply to individual medical problems.